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When it comes to weight-loss supplements, claims that sound too good to be true usually are. At best, supplements often do not live up to their hype, and at worst, they can be hazardous to your health.
About 15 percent of adults in the U.S. have used a dietary weight-loss supplement at some point in their lives, according to the National Institutes of Health’s Office of Dietary Supplements. And that makes for big business. Americans spend approximately $2.1 billion each year on diet supplements in the form of pills, tablets, capsules and soft-gels.
“Many of our patients try over-the-counter weight loss medications prior to seeking bariatric surgery,” said Penn Medicine Bariatric Program Manager, Colleen Tewksbury, PhD, RD. “Unfortunately, what many don’t realize is that even those that have some studies to back them up, only a selected few show a couple of pounds’ advantage over diet and exercise.”
Are supplements FDA-regulated?
The U.S. Food and Drug Administration regulates dietary supplements, including those promoted for weight loss, however, unlike prescription drugs, dietary supplements do not require premarket review or approval by the FDA.
The responsibility of determining the safety of products and the validity of their claims falls on the supplement manufacturers themselves. If the FDA finds a supplement to be unsafe, it will remove the product from shelves or ask the manufacturer to implement a product recall. The FDA and the Federal Trade Commission can also take actions against supplement makers who invent unproven weight-loss claims about their products.
“The FDA does not test products before they hit the shelves,” Tewksbury said. “You can file a complaint and they will investigate and can pull something from the market, but no one other than the company is verifying that what’s listed on the label is actually in the product, unless is it independently verified by another company.”
Supplements also don’t have to go through clinical trials, which are research studies that explore whether a medical strategy, treatment, medication or device is safe and effective for humans.
“Prescription drugs take years to reach consumers due to the regulations around clinical trials and proving their effectiveness and safety, while OTC supplements require absolutely no clinical trials to be sold,” Tewksbury said.
Does Natural Mean Safe?
Many weight loss supplements market themselves as a safe, natural and effective way to lose weight.
However, just because something claims to be natural, doesn’t mean much — ingredients derived from nature can still be harmful.
“Natural is a useless term when it comes to nutrition and supplements,” Tewksbury said. “There is no technical definition for it and it can mean a lot of different things.”
Talk to Your Doctor
The evidence supporting the use of over-the-counter dietary supplements to reduce body weight and stimulate weight loss is inconclusive and unconvincing. However, there are FDA-approved drugs your health care provider might recommend.
“If you are a candidate for weight loss medications, speak with your doctor about FDA-approved options that would be best for you,” Tewksbury said. “Avoid the OTC options. Most, unfortunately, are marketing ploys preying on people desperate for help.”
The only over-the-counter weight loss medication with extensive research behind it is Orlistat, better known by its brand name, Alli.
“It is a lipase inhibitor and causes fat malabsorption when taken with food,” Tewksbury said. “This can lead to absorbing fewer calories and potentially weight loss.”
But the medication has unpleasant side effects.
“The primary side effect of eating too much fat is steatorrhea, or greasy, fatty diarrhea,” Tewksbury said. “This can also lead to fecal incontinence. It can also be a powerful deterrent to eating high fat, high calorie foods.”